Individual
KATHLEEN K SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
6300 ODELL RD, BELTSVILLE, MD 20705-4107
(703) 801-4093
(833) 694-0324
Mailing address
6300 ODELL RD, BELTSVILLE, MD 20705-4107
(703) 801-4093
(833) 694-0324
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
R179174
MD
367A00000X
Advanced Practice Midwife
RN1014773
DC
Other
Enumeration date
12/12/2008
Last updated
03/06/2023
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